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2010-563 4.41" TOWN OF QUE E NSBURY 742 BayRoad, eensb NY 12804-5902 (518)761-8201 ow Qu may, Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20100563 Date Issued: Monday, December 20, 2010 This is to certify that work requested to be done as shown by Permit Number P20100563 has been completed. Tax Map Number: 523400-308-005-0001-019-000-0000 Location: 5 GLEN Ct Owner: STEVEN M LOVERING Applicant: STEVEN M LOVERING This structure may be occupied as a: Septic Alteration Residential By Order of Town Board TOWN OF QUEENSBURY `t'4 B Issuance of this Certificate of Compliance DOES NOT relieve the J ! property owner of the responsibility for compliance with Site Plan, ,. ��� � )(-1 . Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. �` TOWN OF QUEENSBURY `O 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100563 Application Number. A20100563 Tax Map No: 523400-308-005-0001-019-000-0000 Permission is hereby granted to: STEVEN M LOVERING For property located at: 5 GLEN Ct in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: STEVEN M LOVERING GRETCHEN A. LUKE-IZZO Septic Alteration Residential 5 GLEN Ct Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2010-563 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,December 01,2011 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before .. expiration dlte.) Dated at the .wn of p -e43„46 nesday,December 01,2010 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Oti� /� fQ OFFICE USE ONLY • TAX MAP NO. PERMIT NO. /O ' ERMT • FE — C.� ;,� • APPROVALS: ZONING 0 �' TOWN CLERK o,1 f :, IF ui 2010 a APPLICATION FOR SEPTIC DISPOSAL SYSTEM PE IT. 'L . _.y ANCE O _�.=..t A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUFA V ALID( '-- PERMIT. OWNER:OWNER: � .kis Love I'I n& IN STALLER: LA V N ovo r ADDRESS: S 6-1-en C-f-- • ADDRESS: PHONE NOS. —1 LA L' —[b 0 2 ho I —3 I S PHONE NOS. LOCATION OF INSTALLATION: S 6-i er- C-f- . abi 1 YEAR BUILT NO.OF X COMPUTATION= RESIDENCE INFORMATION: BEDROOMS = TOTAL DAILY FLOW 1980 or older X 150 gallon per bedroom = GARBAGE GRINDER INSTALLED? N 0 1981 -1991 X 130 gallon per bedroom = 1992 present Li X 110 gallon per bedroom = SPA OR HOT TUB �"i y O INSTALLED? N O PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling \ Steep slope %Slo e p ✓ SOIL NATURE: Sand V Loam Clay Other ✓ GROUNDWATER: At what depth? N I r)' ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? i+ ' ✓ DOMESTIC WATER SUPLY: Municipal ✓ Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is ) 'Y per minute per inch. (Test to be completed by a licensed professional engineer or architect.) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). TANK SIZE: I,a5 o GALLON (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. p SYSTEM TYPE: ABSORPTION FIELD (WITH NO. 2 STONE) Total length aa-S— ft. Each trench S x 9 S ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? ' NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST . ..............._.. . i. APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIIDEDED BY A TOWNi. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. 1111. Septic Inspection Report Office No. (518)761-8256 Date Inspection req �� -• `J edt Queensbury Building&Code Enforcement Arrive: i . , j 1 j in am/ 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia-:7 NAME: PERMIT NO.: G -c'�C0 LOCATION: 5 C-,'L._e_i;_ C uo cc. XNSPECT ON: 17 — 1(0-1t) RECHECK: Comments and/or diagram Soil Type: Sand Loam/Clay Type of Water: unici Well Water Waterline separation distance 1© ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NO] Absorption Field: Total length " L.-) ft. Length of each trench zfi " at. Depth of trenches Z- ?-t ft. SimorguSisrie 11JF\cTRATc i Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Ht' AzCt�40 .�\ST i iG Tank to Distribution Box y \iCDistribution Box to Field/ Pit L I i 1\/C, T) 11•��1 <Ti2t 'vr 1Opening Sealed: / Hit N End Cap -71T _N Inlet/Outlet Pipes&Baffles if N Manholes 12"or less below grade ,/Y_N [P Location/ Separations Foundation to tank •"rft. F----Y-15\--1 l Foundation to absorption Art ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y—N ETU Maintenance Contract Y N provided Location of System on Property: Front r Left Side Right Sid Middle Front Middle Rear s m Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Fomis\Inspection Forrns\Septic Inspection Report_03 29 10.doc 7LrscJ • Septic Inspection Repo Office No. (518)761-8256 Date Ins n reEe' e j Queensbury Building&Code Enforcement Arrive: IV).4.1-) S'` •: •' P.: ••rt: 1 \-c(1-113/Orn 742 Bay Rd., Queensbury, NY 12804 Inspecto's Initials: NAME: /P�'L'erl . 1 'r LOCATION: 3 �1 o SPECT ON: RECHECK: Comments and/or diagram Soil Type: • •.m/Clay Type of Water: uniapal Well Water Waterli .ration distance _IQ—ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NO] Absorption Field: Total length o'" ft. Length each s ft. D � ���� gB �i3U O Depth of trenches ft. Size of Stone C hA 6\--F ( 2_!'eCA Seepage Pits: Number Size: e_ x —2-- Stone Size: Piping Size Type Building to tank ' " H \AC: X l6- -1 Tank to Distribution Box y '' PVC Distribution Box to Field/ Pit Opening Sealed: /1" N End Cap ,� N Iniet/Outiet Pipes&Baffles N Manholes 12"or less below grade [prpv $xten •,• .• lar' Y- Location/ Separations Foundation to tank kcrQ ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y N ETU Maintenance Contract _Y N provided Location of System on Property: Front R- •r Left Side Right Side Middie Front diddle Rear - - S • . Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Fofms\Inspection Forms\Septic Inspection Report_03 29 10.doc \--A. oN ei/(7 / 4 / i , xl. i ' 4) \ \ A CD Lig. N �'� ��+moi _ 't -�� / atr+4�ij+�+� 1 ,/ 1164 AM. 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